Summer Tech Innovators Bootcamp - Student Enrollment

Form Elements

• text Student Full Name Required
• email Student Email Address Required
• phone Student Mobile Number Required
• date Student Date of Birth Required
• dropdown Current Grade Level Required
• checkbox Technology Areas of Interest
• radio Coding Experience Level Required
• text Parent/Guardian Name Required
• email Parent/Guardian Email Required
• phone Emergency Contact Number Required
• textlong Medical Considerations
• checkbox Program Agreement Required